Menstrual health and hygiene practices: addressing stigma through school health services programs in Karachi, Pakistan

Purpose Menstrual health and hygiene (MHH) is often considered taboo, limiting open discussion among young girls. School-based health programmes can therefore play a crucial role in addressing this gap by raising awareness and providing education on appropriate and adequate MHH practices. Methods A school-based cross-sectional study was conducted in four public schools serving underprivileged populations. Schools were selected using a random selection, while convenience sampling was used to recruit eligible female students. Girls aged 10–20 years who had attained menarche were included, resulting in a total sample of 880 participants. Data were collected using a structured questionnaire that included questions related to menstrual health and hygiene. Results A total of 880 female students were included in the analysis, with a mean age of 15.41 ± 1.62 years and mean age of menarche of 12.40 ± 1.00 years. Overall, 51.5% of participants had prior awareness of menstruation. The most common source of information was family members (53.0%), followed by school (34.4%). Sanitary pads were the predominant menstrual material used (77.5%). Maternal education and age were significantly associated with menstrual awareness and hygiene practices. Girls whose mothers had higher levels of eduaction were more likely to have menstrual awareness and used sanitary pads (p 0.02). Younger adolescents (10–13 years) were more likely to lack prior menstrual knowledge compared to older age group (14–16 years). Discussion This study highlights significant gaps in menstrual health knowledge and hygiene practices among adolescent girls in underprivileged school settings, strongly influenced by maternal education. Integrating menstrual health education into school-based programmes, alongside improved access to menstrual products and sanitation facilities, is essential to address these disparities.